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SANJ O A Q U I N Environmental Health Department <br /> — COUNTY <br /> Sweet Sorghum Roasted Coffee <br /> ❑ Syrup El (Beans/Grounds) ❑ Chocolate Covered Nonperishable Food <br /> Fried or Baked <br /> El Donuts and WafflesElDried Hot Chocolate ❑ Other <br /> ' Do not contain eggs,cream,or cream cheese <br /> "If preparing jams,jellies or fruit butters,include a list of ingredients(attach separate page if needed). These items <br /> must comply with standards described in Part 150 of Title 21 of the Code of Federal <br /> Regulations http://www.accessdata.fda.cov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150 <br /> Food Descriptions: <br /> 0k-M RL Wwa' Wq-w owrmmmSw) Wyava, Wmu ChICOOT-Oh?, <br /> gbuA cxrocot,wT ctnP , 1 ►uT �tTt�R• <br /> 2 of <br /> EHD 16-27 6/29/17 CFO REGIPERMIT71NG FORM <br />